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Ambulatory Care Coordinator

Company: Apollo Medical Holdings, Inc.
Location: Monterey Park
Posted on: May 3, 2021

Job Description:

SUMMARY

Assist Ambulatory Care Management Nurse with the day-to-day care management responsibilities; to efficient and effective ambulatory care management to eligible population.

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Complies with NMM and department policies & procedures to ensure all appropriate assessment for the eligible population are completed and acted upon within established timeframes.
  • Assist Ambulatory Care Management Nurse with day-to-day activities.
  • Responsible for data collection to assist ACM nurse with assessment and care plan implementation but not limited to:
  • Eligibility verification
  • Create member chart
  • Health plan portal data download (HRA, Member profile, etc.)
  • Authorization/Claim history
  • Request medical records from physicians for review.
  • Create case (EZ-Cap/EZ-Care)
  • Case load: Minimum 10 per day.
  • Responsible for member/provider notification (telephonic and/or written) utilizing department templates.
  • Scan and file any applicable information to appropriate folders.
  • Scan and file returned member mailings to appropriate folders.
  • Notify ACM Nurse any change in members' status (unable to reach, opt-out, agree to join)
  • Responsible for follow-up call and returning department calls.
  • Participates in all health plan and department meetings and trainings as applicable.
  • Assist with health plan audit preparation.
  • Maintains strictest confidentiality at all times.
  • Performs other duties, projects and actions as assigned

QUALIFICATIONS:

  • High School Graduate or equivalent
  • Experienced in managed care environment to include but not limited to health plan, IPA or MSO preferred.
  • Knowledge of medical terminology, ICD-9, ICD-10, CPT codes.
  • Proficient with Microsoft Office (Word, Excel, Power Point) and EZCAP
  • Good organizational skills.
  • Excellent written and oral communication skills, as well as strong interpersonal, critical thinking and analytical skills.
  • Must have the ability to multitask and problem solve in a fast pace work environment
  • Personal & Professional Qualities
  • Punctuality, detail oriented, creativity, etc. would be helpful for this position
  • Ability to follow directions and perform work independently according to department standards
  • Able to function effectively under time constraint
  • Able to maintain confidentiality at all times
  • Willingness to accept responsibility and desire to learn new task
  • Must be a strong team player, punctual and have excellent attendance record.

Keywords: Apollo Medical Holdings, Inc., Monterey Park , Ambulatory Care Coordinator, Other , Monterey Park, California

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